The forum said local commissioning consortia, originally designed to comprise GPs only, should have input from a range of health and social care professionals through advisory “senates”.

“Almost every group we met expressed fears that the proposed legislation is insufficient to guarantee that all relevant professions will be involved in commissioning decisions,” said the forum.

Other proposals include:-

That the boundaries of local commissioning consortia should not normally cross those of local authorities to protect joint owkring.

That regulator Monitor’s duty to promote competition in health services should be replaced by a duty to should support choice, competition and integrated care.

That health and well-being boards, which are due to oversee health and social care commissioning locally, should be beefed up to better enable them to hold commissioners to account.

That patients and carers should be equal partners with healthcare professionals in decision-making.

The recommendations have been broadly welcomed by health and social care leaders.

“Many of the leading health charities have taken the opportunity of the listening exercise to voice their concerns about NHS reform – so we are delighted that some of those concerns have been listened to and turned into recommendations,” said Paul Jenkins, chief executive of mental health charity Rethink.

“In particular, we welcome the idea that patient involvement should be ‘hardwired’ into the system at every level – meaning patients will be given more of a say over their own care and treatment.”

Older people’s charity WRVS said it had feared the prospects of NHS-funded services being subject to increased competition because of the risk of care being fragmented. It added: “WRVS therefore strongly supports the recommendation that the regulator, Monitor, will now be given a duty to promote collaboration and integration within health and social care which will make a real difference to the care of older people.”

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